HAIC在不可切除肝癌合并高流量肝动脉门静脉瘘的短期疗效及安全性OACSTPCD

Objective To observe the short-term efficacy and safety of FOLFOX-HAIC in treatment of unresectable hepatocellular carcinoma combined with high-flow hepatic arterioportal shunts(APS).Methods The clinical data of 30 patients with unresectable hepatocellular carcinoma combined with high-flow APS who received FOLFOX-HAIC from Jun.2020 to Jan.2023 were retrospectively collected(HAIC group),and the clinical data of 30 patients in the same target population who underwent transcatheter arterial chemoembolization(TACE)during the same period were also collected(TACE group).The APS improvement rate,objective response rate of tumors and adverse reactions were compared between the two groups.Results The HAIC group showed significantly better results in terms of APS improvement rate(83.3%vs 56.7%,χ2=5.079,P=0.047),objective response rate of tumor lesions(76.7%vs 46.7%,χ2=5.711,P=0.017)and median progression-free survival(PFS)(9.5 months vs 5.4 months,Log-rank χ2=10.832,P=0.001)compared to the TACE group.The incidence of thrombocytopenia in postoperative patients was significantly higher in the HAIC group than in the TACE group(P<0.05).On the other hand,the incidence of postoperative patients with increased alanine transaminase and alkaline phosphatase was significantly higher in the TACE group than in the HAIC group(P<0.05).No serious adverse events were observed.Conclusion HAIC is effective and safe treatment option for improving fistulas and controlling tumors in patients with unresectable hepatocellular carcinoma combined with APS.